BILL ANALYSIS                                                                                                                                                                                                    






                        SENATE HEALTH AND HUMAN SERVICES
                               COMMITTEE ANALYSIS
                        Senator Martha M. Escutia, Chair


          BILL NO:       SB 1770                                      
          S
          AUTHOR:        Chesbro                                      
          B
          AMENDED:       April 13, 2000
          HEARING DATE:  April 26, 2000                               
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          FISCAL:        Appropriations                               
          7
                                                                      
          7
          CONSULTANT:                                                 
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          McCarthy / ak
                                        

                                     SUBJECT
                                         
              Mental Health:  client and family member empowerment  
                                    programs

                                     SUMMARY  

          SB 1770 establishes a mental health client and family  
          empowerment grant program to enhance the role of clients  
          and families in the mental health system, as well as  
          improving the responsiveness of the mental health system to  
          clients and family members. 

                                     ABSTRACT

           Existing law:
           Requires the state Department of Mental Health (DMH) and  
            county mental health departments to administer a number  
            of programs to provide services to persons who have a  
            mental illness;

           Provides that under Realignment, federal and state  
            Medi-Cal funds plus a portion of tax proceeds, are  
            provided to county mental health departments, which have  
            primary responsibility to provide mental health care to  
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            county residents.
           
          This bill:
           Makes Legislative findings regarding the value of  
            improving involvement of mental health clients and family  
            members in the delivery of mental health services;

           Establishes a client and family empowerment grant program  
            to enhance the role of clients and families in the county  
            mental health programs;

           Requires county applications for grant funds to include,  
            among other requirements, plans to expand:  (1) training,  
            information and referral services for clients and family  
            members, and (2) client self-help programs and  
            family-to-family support activities.



                                 FISCAL ANALYSIS
           
          SB 1770 states that the DMH's responsibilities under this  
          bill would apply in any year in which funds are provided  
          for that purpose in the annual budget act. 

                            BACKGROUND AND DISCUSSION
           
          1.County Mental Health Program Services
            Existing law establishes the county mental health  
            departments as the primary providers of mental health  
            care.  Under Realignment, counties currently serve  
            approximately 200,000 persons with mental health  
            disorders annually. 

          2.Joint Committee on Mental Health Reform
            In January, 2000, the Legislature created, through SCR  
            59, a Joint Committee on Mental Health Reform with the  
            purpose of identifying promising strategies and policy  
            recommendations relating to mental health treatment.  The  
            Joint Committee has held public hearings in Sacramento,  
            Los Angeles, Santa Rosa and Oakland to receive testimony  
            of clients, family members, service providers and  
            advocates on recommendations for improvement of  
            California's mental health system. 

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            The Joint Committee received testimony on the status of  
            the mental health system and gaps in needed services.  A  
            number of witnesses testified to lack of information  
            about, and access to, the mental health system.  Also,  
            clients testified to the value of peer support  
            activities, including self-help groups and  
            family-to-family support programs.

          3.Legislative intent and grant program
            SB 1770 makes a number of Legislative findings including:
              persons with mental illness and their families make  
               significant contributions toward the development of a  
               cohesive, high-quality mental health system, which is  
               enhanced when clients and family members are afforded  
               choices about methods of service delivery;
              clients and families should have a leadership role in  
               the development, implementation, and oversight of  
               mental health policies;
              counties should improve the exercise of consumer  
               choice in the determination of mental health treatment  
               and service programs;
              delivery of appropriate and effective mental health  
               services and supports is improved by the involvement  
               of clients and families in the development of   
               treatment and service plans;
              peer supports improve the participation of both  
               clients and family members in the mental health  
               system.

















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            SB 1770 requires DMH to administer a program of  
            competitive grants for county mental health programs that  
            improve services and supports for clients and families.   
            Proposals would be required to contain, among other  
            requirements, descriptions of how funds would result in:
              establishment, expansion or improvement of training,  
               information and referral services for clients and for  
               family members;
              expansion of the role of clients and family members in  
               the development of local policy;
              establishment or expansion of self-help and other  
               client-run programs as well as family-to-family  
               support activities;
              improved decision making and choices of clients and  
               family members.

            Proposals also would be required to demonstrate that (1)  
            clients and family members participated in the  
            development of the proposal and (2) how the programs will  
            continue after state funding is terminated.  

          1.Arguments of Supporters
          The author's stated purpose in introducing this bill is to  
            address a recurring theme noted during hearings of the  
            Joint Committee on Mental Health Reform:  

               "?there is a lack of respect and partnership felt by  
               clients and family members in the mental health  
               system.  They lack information, access and a  
               meaningful role in system design and implementation.   
               The Committee also repeatedly heard from clients and  
               families who had benefited through peer support  
               activities, including self-help programs and  
               family-to-family support programs".

            In support of this bill, the California Network of Mental  
            Health Clients argues that:  "Self-help groups, instead  
            of treating individuals as diagnoses and labels, respect  
            them as human beings?thus developing service responses  
            that deal with the whole person.  Self-help groups work  
            for many reasons, not the least of which is that clients  
            see other clients in positions of authority, as role  
            models, and thus have more confidence in their own  
            capabilities."  Protection and Advocacy, Inc. comments in  
            support of this bill that it:   "?is consistent with the  




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            principle that persons receiving mental health services  
            should be allowed to participate in every aspect of their  
            treatment, as are persons who receive other kinds of  
            health services."

                                    POSITIONS  

          Support:       California Child, Youth and Family Coalition
                         California Network of Mental Health Clients
                         NAMI California
                         Protection and Advocacy, Inc.

          Oppose:   None received




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